Edward Jenner's 1794 accompt-book for the pocket or desk.

Edward Jenner's early career, as a country surgeon and apothecary for over twenty years, is obscure in contrast to the later publicity generated by his vaccination work and practice as a consulting physician in Cheltenham Spa. This is due, in part, to the meagre survival of letters and practice records from 1772, the year he commenced work in Berkeley, Gloucestershire, on completing an assistantship with John Hunter,1 until 1798 when he published An inquiry into the causes and effects of the variolae vaccinae. In response to this memorable event his activities became more fully documented. In 1792, supported by Dr C H Parry2 and Dr J H Hickes,3 Jenner sought and was awarded a doctorate of medicine from St Andrews University with a view to modifying his practice when two nephews became his assistants. By 17 April 1794, Henry Jenner had joined his uncle for, on that day, Henry was called to see a poisoned traveller lodging at a nearby inn on the Gloucester road; both uncle and nephew provided evidence at the subsequent murder trial.4 The second nephew, George Jenner, was sharing the practice by December 1794 according to an undated letter from Jenner to W F Shrapnell reproduced by Baron.5 Following a long illness in the winter of 1794-95, Jenner recuperated in Cheltenham before starting consultant practice at its developing Spa during the summer of 1795.6 Hence, 1794 was the last complete year he practised exclusively from Berkeley. By chance, Jenner's only surviving patient appointment diary or "accompt-book" is that